title: Retrospective medical record review of an osteopathic manipulative medicine hospital consultation service.
abstract: BACKGROUND
  In the first half of the 20th century, nearly all osteopathic physicians used osteopathic manipulative medicine (OMM) in the care of hospitalized patients. Over the past few decades, however, inpatient OMM care has declined and is more commonly provided by OMM specialists.
  
  
  OBJECTIVE
  To retrospectively evaluate the details of a specialty-level OMM inpatient consultation service.
  
  
  METHODS
  Inpatient OMM consultations that took place at Northeast Regional Medical Center in Kirksville, Missouri, between July 1998 and March 2008 were identified from billing records. Consultations were reviewed for demographic information, admission location, postoperative status, intensive care unit and mechanical ventilation usage, admission and discharge diagnoses, consultation reasons and final diagnoses, areas of somatic dysfunction treated and types of osteopathic manipulative treatment (OMT) techniques used, and hospital length of stay (LOS).
  
  
  RESULTS
  A total of 1509 OMM consultations were identified (580 for male patients [38%]; 929 for female patients [62%]; mean [SD] age, 54 [31] years [range, 0-99 years]), representing 11% of all inpatient consultations. Of these, 1372 consultations (91%) were initiated in the inpatient acute care facility, 87 (6%) in the inpatient acute rehabilitation facility, and 50 (3%) in the skilled nursing facility. Further, 265 consultations (18%) were for postoperative patients, 187 (12%) were for patients in the intensive care unit, and 54 (4%) were for patients receiving mechanical ventilation at the time of the consultation. The most common admission diagnoses were hypertension, routine newborn care, lower respiratory infection, chronic obstructive pulmonary disease, and gastrointestinal symptoms. The most common reasons for OMM consultation were chest/rib pain, spinal pain, lower respiratory infection (adjunctive treatment), cranial asymmetry, and infant feeding disorder. The most common types of OMT techniques used were myofascial release, balanced ligamentous tension, muscle energy, soft tissue, and inhibition. The mean (SD) LOS was 5.7 (3.3) days (range, 0-48 days), while the mean (SD) number of days the patient received OMT was 3.1 (2.2) days.
  
  
  CONCLUSIONS
  Medical records reviewed in the current study revealed that OMM consultations were ordered primarily for musculoskeletal complaints, respiratory problems (adjunctive treatment), and newborn care. A variety of OMT techniques were used. Further retrospective study is warranted to determine if OMM had an effect on LOS.
authors.affiliation: Department of Osteopathic Manipulative Medicine, A.T. Still University-Kirksville College of Osteopathic Medicine, 800 W Jefferson St, Kirksville, MO 63501-1443. ksnider@atsu.edu.
authors.forename: Karen T
authors.initials: KT
authors.lastname: Snider
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Snider
authors.forename: Brett R
authors.initials: BR
authors.lastname: DeGooyer
authors.forename: Allison M
authors.initials: AM
authors.lastname: Bukowski
authors.forename: Regina K
authors.initials: RK
authors.lastname: Fleming
authors.forename: Jane C
authors.initials: JC
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006753:Hospital Records; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients; D007902:Length of Stay / Q000639:trends; D008297:Male; D026301:Manipulation, Osteopathic / Q000706:statistics & numerical data*; D008875:Middle Aged; D008923:Missouri; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult